Clinical Audits in Outpatient Clinics for Chronic Obstructive Pulmonary Disease: Methodological Considerations and Workflow

作者：Luis Lopez Campos Jose; Abad Arranz Maria; Calero Acuna Carmen; Romero Valero Fernando; Ayerbe Garcia Ruth; Hidalgo Molina Antonio; Aguilar Perez Grovas Ricardo Ismael; Garcia Gil Francisco; Casas Maldonado Francisco; Caballero Ballesteros Laura; Sanchez Palop Maria; Perez Tejero Dolores; Segado Alejandro; Calvo Bonachera Jose; Hernandez Sierra Barbara; Domenech Adolfo; Arroyo Varela Macarena; Gonzalez Vargas Francisco; Cruz Rueda Juan Jose

来源：PLos One, 2015, 10(11): e0141856.

DOI：10.1371/journal.pone.0141856

Objectives
Previous clinical audits for chronic obstructive pulmonary disease (COPD) have provided valuable information on the clinical care delivered to patients admitted to medical wards because of COPD exacerbations. However, clinical audits of COPD in an outpatient setting are scarce and no methodological guidelines are currently available. Based on our previous experience, herein we describe a clinical audit for COPD patients in specialized outpatient clinics with the overall goal of establishing a potential methodological workflow.
Methods
A pilot clinical audit of COPD patients referred to respiratory outpatient clinics in the region of Andalusia, Spain (over 8 million inhabitants), was performed. The audit took place between October 2013 and September 2014, and 10 centers (20% of all public hospitals) were invited to participate. Cases with an established diagnosis of COPD based on risk factors, clinical symptoms, and a post-bronchodilator FEV1/FVC ratio of less than 0.70 were deemed eligible. The usefulness of formally scheduled regular follow-up visits was assessed. Two different databases (resources and clinical database) were constructed. Assessments were planned over a year divided by 4 three-month periods, with the goal of determining seasonal-related changes. Exacerbations and survival served as the main endpoints.
Conclusions
This paper describes a methodological framework for conducting a clinical audit of COPD patients in an outpatient setting. Results from such audits can guide health information systems development and implementation in real-world settings.

• 出版日期2015-11-6